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Stories of grit & miracles
Success Story: Overcoming Complex Respiratory Challenges

Watch this video to witness the inspiring journey of Mr. Hiranmoy Singha at #AMRIHospitals, Mukundapur's #CriticalCareUnit. Admitted with severe asthma exacerbation, pneumonia, and respiratory failure, his complex respiratory challenges were compounded by underlying kyphoscoliosis and restrictive lung disease. However, with the expertise of Dr. Mrinmoy Mitra and the dedicated #CriticalCareTeam, along with the collaborative efforts of the nursing, physiotherapy, and dietary staff, Mr. Singha defied the odds. After more than three weeks on mechanical ventilation, he was successfully decannulated and is now making remarkable progress, even regaining the ability to walk with support. Keep an eye on our #YouTubeChannel to witness more tales of resilience and exceptional care.

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What to be done in trauma...#Role of plastic surgeon in trauma....#educate yourself.

Here a young guy has suffered a glass cut injury to right hand because of accidental fall over aqurium while feeding his beloved fishes at home.

There was heavy bleeding from the cut as big blood vessels were cut. He was unable to move his wrist and hand as all the nerves muscles from volar aspect were transected . He immidiately rushed to AMRI hopital emergency. Within few hour operation was excuted by Dr Sanjibani sudha and her team. He was kept in the hospital for 5 days and discharged with the advise of physiotherapy and few drugs. He followed all the advises sincerly and here is the result. Now he can use his hand as before and his beloved pet totoo is also preserved.

What one should do in a major trauma?

Here is a case of glass cut injury right forearam volar aspect with both the vessel trasected (Radial ulnar) both the nerve cut (Median ulnar) and all the volar muscles cut (FDS,FDP,FCR,FCU,PT).Pt presented to hospital with in 2 hr of trauma and sx was performed immidiately with repair of all mentioned structures. Pt follwed all the post op advises, physiotherapy and here is the result with full range of active flexion,extension at wrist and fingers. #happypatient.

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A 43-year-old man's six-month journey back to normal life after a massive heart attack

This 46-year-old gentleman was admitted to our hospital AMRI DHAKURIA in the middle of the night with low BP, chest discomfort, and severe shortness of breath. He was diagnosed with a massive heart attack one day old. After initial stabilization, Noradrenaline infusion (a unique drug for increasing blood pressure) was started, and a blood thinner was given. Noninvasive ventilation was also started.

The next day with all this support, he was taken to the cath lab for angiography, which showed that three out of two arteries were 100% blocked, and the right-sided artery was the main culprit for this heart attack. Echocardiography revealed that heart pump function was only 30% which is 60% in ordinary people. So, we first open the block of the right coronary artery (RCA). After the initial stormy first post-operative day, the patient gradually started to improve; we were able to wean them off his support, and on day 5, finally, we were able to discharge the patient with a BP of 90/60 and a heart pump function of 32%. But even after discharge patient was not entirely well and complained of shortness of breath and little chest pain. So, after one month, we decided to bring back the patient and open the left-sided coronary artery (LCA); this time, the procedure was technically challenging, but after two hours of effort, we could finally able to open the artery, this time, after two days we discharge the patient. The post-operative course this time was a bit better than the previous one, but the patient's blood pressure was mainly on the lower side. We could not introduce all the heart failure medications because of a few episodes of symptomatic hypotension. Still, we followed the patient at timely intervals, did an echo every month, and finally, his pump function increased to 46% at the end of 6 months, and his blood pressure also became stable. This time we could also introduce all the heart failure medicines, and now, after six months, he can join his work again.

So, the satisfaction is seeing the smile again on your patient's face.

This photo is taken with the permission of the patient and the patient's party.

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An elderly man got successful TAVI at AMRI Hospitals Bhubaneswar

An elderly man got successful TAVI at AMRI Hospitals Bhubaneswar

An 83-years-old man was admitted with recurrent fainting (loss of consciousness) and breathlessness. On evaluation he was found to have severe calcific aortic stenosis. The treating doctor, Dr. Dibya Ranjan Behera, Cardiologist, AMRI Hospitals Bhubaneswar said, “This is a heart disease where one of the valves, which connect the left ventricle with the aorta  was tightly stenosed. In simple words, the exit gate of the left side of  heart was almost blocked so that oxygenated blood was unable to go the major blood pipe at the speed which is required. When such patient do slightest exertion blood flow to the brain decreases and he will get fainting attack, which is sometimes deadly. Coronary arteries also got less blood flow and he will get chest pain (angina) and even heart attack. The blood in the lungs get stuck and causes breathlessness.”

This is one of the very fatal (deadly) diseases which should be immediately treated. The treatment is simply replacing the damaged aortic valve called "Aortic Valve Replacement (AVR)". This was usually  done by open heart surgery.

He also said, "But in many patients like very elderly, with other severe comorbidities open heart surgery is considered as high risk. Recently with the advancement of science, this procedure can be done by catheter intervention only, without need of open heart surgery. This is called Transcatheter Aortic Valve Implantation/Replacement ( TAVI/ TAVR).

“TAVI has revolutionized modern day cardiac intervention in terms of its usefulness and benefits in elderly high risk patients."

A cardiac team led by Dr. Behera  did  TAVI successfully using balloon expandable valve-  MyVal in this 83-years-old gentleman. Needless to say that he was discharged home within 2 to 3 days of the procedure. Now he was able to do all his works without any symptoms.

The patient and the patient family are very happy and expressed their gratitude to AMRI Hospitals management as well as the treating doctors Dr. Biswajit Mohapatra (CTVS surgeon), Dr. Vivek Chowdhury and Dr B. Rath, Cardiac anesthesiologists and entire Cathlab team, CCU team for this remarkable accomplishment.

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AMRI Doctors replaces Aortic valve with TAVR

A 78-year-old patient from Paradip, Odisha, underwent successful heart Aortic valve replacement with TAVR (Transcatheter Aortic Valve Replacement) without open- Heart surgery by a team of doctors led by Interventional Cardiologist and structural Heart Disease specialist, Dr J K Padhi, Director, Cardiology, AMRI hospitals Bhubaneswar.

The patient was suffering from Severe Aortic stenosis. Due to the above heart problems, he was finding difficulty in doing his Daily activities and would become short of breath on minimal exertion. The patient was advised Surgical Aortic valve replacement (SAVR). But due to high risk surgery was denied and patient was plan for onsurgical treatment doing TAVR.

He was also hospitalized for heart failure at his home town. Due to the severe narrowing of the Aortic valve, medicines were not working for his disease, and the only treatment offered was valve replacement. Dr Padhi replaced Aortic valve by performing TAVR, non-surgically at AMRI Hospitals Bhubaneswar.

“This transcatheter native Aortic valve replacement now performed worldwide and is the first case in AMRI Hospitals Bhubaneswar. This treatment has brought a new ray of hope for the patient and his family.” Said, Ms Nilanjana Mukherjee, Vice President & Unit Head, AMRI Hospitals Bhubaneswar.

“Aortic stenosis refers to the narrowing of the Aortic valve. Aortic valve is the outflow valve that controls the oxygenated blood flow from the heart to the body.

Narrowing of Aortic valve creates a life-threatening situation called Aortic stenosis and heart failure.”, said Dr. Sidharth Mishra, Medical Superintendent, AMRI Hospitals Bhubaneswar.

The patient was admitted to the hospital with the condition of heart failure, a history of shortness-of-breath, difficulty in walking, and carrying out daily activities.

Traditionally such patients are treated with open-heart surgery.

“Whether TAVR or SAVR is more appropriate for a given individual depends on multiple factors and is discussed with each patient by a heart team comprising of both an interventional cardiologist and a cardiac surgeon. Now-a-days, TAVR is mostly recommended in elderly frail individuals having previous history of heart surgery, brain stroke and comorbid systemic disease involving lungs, liver and kidney.

TAVR when compared to surgery is safer in selected patients.” Said, Dr. J K Padhi, Director, Cardiology, AMRI hospitals Bhubaneswar.

FAQ

What is TAVR?

Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure to replace the Aortic Valve in patients with diseased Aortic valve. The development TAVR has emerged as a lifeline for patients considered to be inoperable by open heart surgery also called as surgical Aortic Valve Replacement (SAVR).

How to prepare for TAVR

The heart team will access the patient’s general condition through various imaging (TVAR CT protocol / Coronary angiography) and blood tests before TAVR surgery, to confirm the condition of the patient’s lungs and heart. The team will also advise a heart ultrasound to the patient to estimate aortic valve.

How TVR Works?

During TAVR, interventional cardiologist inserted a catheter through a small cut in the skin over the blood vessel in the groin to deliver and implant the artificial valve which anchors over the diseased valve. TAVR procedure typically takes less than one hour and usually done under mild sedation or general anaesthesia.

Recommendations post TAVR recovery

After the procedure, the patient will be transferred to the intensive care unit (ICU), so as to closely monitor the patient for any redness, swelling or bleeding from the groin site. They are prescribed blood thinners during discharge. Most patients go home the next day and are allowed to resume their normal activities.

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Heart attack patient’s life saved with Penumbra device

A 53 year old gentleman who was suffering from acute chest pain for about four hours came to AMRI Dhakuria’s Emergency in the midnight.
The ECG showed a massive heart attack. The patient was immediately admitted for a Primary Angioplasty, when an Angiogram revealed a huge blood clot in the arteries of the heart.
The clot was very efficiently removed with the help of Penumbra thrombosuction and the blood flow was restored followed by placing a stent. A precious life was saved in the most rapid process.
The super hero of this rescue operation was Penumbra Device. It is a latest generation instrument to address the challenging medical conditions related to huge clots in the arteries.Penumbra thrombectomy device is a specialized mechanical thrombus aspiration system which consists of a motorized pump and a special type catheter. This system works very effectively in cases of large thrombus (clot) because the specialized catheter disintegrates large
chunk of thrombus into small parts and the mechanical pump aspirates the clot. Generally it is used in large arteries like brain or arteries of legs or in pulmonary arteries. It is not commonly used in coronary arteries,
because CAT catheter may cause damage when rotating in a small sized coronary artery. But with a modified technique our cardiology experts connected normal thrombo aspiration catheter with Penumbra mechanical pump. This leads to outstanding results as the thrombo suction flow improves significantly and the stent insertion becomes
smooth and faster. This technique gave outstanding end result in previous cases too. Cudos to our Cardiology team.

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In a rare occurrence, a 61-year-old patient suffered an acute subdural haematoma or bleeding in the brain two days after being detected with dengue

Kolkata, 02.11.2022: In a rare occurrence, a 61-year-old patient suffered an acute subdural haematoma or bleeding in the brain two days after being detected with dengue. Doctors believe that while they have read about cases of dengue-induced cerebral haemorrhage in medical textbooks, none of them have ever come across such a case in recent times.

Tapan Biswas, a resident of Shahidnagar in South Kolkata, visited the OPD of AMRI Hospital Dhakuria on 27th September, 2022 with high grade fever, and was admitted after he tested positive for dengue. Dr Mahuya Bhattacharjee, Senior Consultant, Internal Medicine & Critical Care, the supervising physician of Mr BIswas, said, “When Mr Biswas had come to the OPD on 27th September, he came walking by himself and had no neurological complaints.”

Although Mr Biswas was otherwise stable, from 29th September afternoon he started complaining of severe headache, suddenly lost consciousness, and slipped into coma. “He was put on ventilator and a CT scan revealed that Mr Biswas had suffered an acute subdural haematoma, which was definitely triggered by dengue,” said Dr Bhattacharjee, who had treated Dr Biswas for COVID-19 during the Delta wave. She, however, was clear that COVID-19 did not have any role to play in his recent complications.

Consultant Neurosurgeon, Dr Nirup Dutta, who lead the surgery team, said, “There was a sizeable blood clot between his brain and skull, which was putting immense pressure on the brain. We operated on him that same night and after a two-hour-long surgery managed to clear the area of any clots. We cut out a piece of the skull and put it in an abdominal pocket so that it stayed healthy and we can put it back later. We conducted the surgery while he was still in coma and he was put back on ventilator.”

Dr Dutta explained that the severity of a coma is measured by the Glasgow Coma Scale on a range of 3 to 15, with 3 being the worst and 15 being the best condition. “Mr Biswas measure 4 on the coma scale but we managed to revive him. After the surgery, he was on ventilator for seven days, after which he was extubated and discharged on 10th October,” he said. Dr Bhattacharjee pointed out that when Mr Biswas visited for his first review on 1st November, he was able to walk by himself and there are no neurological deficits

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Here is a success story from NICU of AMRI Hospitals Bhubaneswar. 

700-grams premature baby born at 25 weeks(6month) got a new life at AMRI Hospitals Bhubaneswar  

AMRI Hospitals Bhubaneswar’s NICU team saved an 700-gram premature baby with multiple problems and issues. Here's how the medical staff at AMRI Hospitals Bhubaneswar saved the newborn baby's life.  

A woman from Puri, Odisha delivered girl child at just 25 weeks of her pregnancy in the month of June.  

After the conceiving  baby, the Parents were doing their regular check ups with Dr Monica Gupta, Gynecolgy, AMRI Hospitals. When the premature delivery happened, the desperate parents, with an aim of saving the surviving neonate, approached the department of Paediatric & Neonatology, AMRI Hopspitals.  

The baby received a thorough treatment and care under the care of Dr. Janaki Ballav Pradhan, Dr. Monica Gupta and the NICU Team of AMRI Hospitals Bhubaneswar. "The baby was extremely small and she had all the complications of prematurity. There were many continuous challenges during the treatment. The baby received 3 doses of surfactant, on ventilator support for 1 month and treatment for closure of patent ductus arteriosus. After that when she developed pneumonia and sepsis, we almost lost hope, but the baby was a fighter. With the efforts of all our nurses and doctors, we were able to overcome those issues. She is now healthy and neurologically normal. We are incredibly happy that we were able to save her life and send her home happily with her parents," said Dr Janaki Ballav Pradhan & Dr Monica Gupta who were the treating Doctors of the baby.  

"Extreme prematurity with less than 26 weeks especially with birth weight of 700-grams or less rarely survive without any neurological sequalae. Only a few case reports of this kind are found internationally. After a long wait and a lot of complications ventilator dependency, many blood transfusions  baby's general condition improved. After 102 days, the mother is feeding the baby directly and the baby discharged from the hospital with  weight of 2kg with normal neurological activities with normal hearing and eye condition” Said, Dr Janaki Ballav Pradhan. 

Treating Doctors:

Dr Janaki Ballav Pradhan , MBBS, MD (Paediatrics) , DM (Neonatology), FIAP, Consultant, Neonatology & Paediatrics

Dr. Monica Gupta, MD (AIIMS, Delhi), DM Reproductive Medicine & Surgery (AIIMS, Delhi), MRCOG (London, UK), Ex Consultant AIIMS , Delhi, Senior Consultant O&G - AMRI Hospitals, Bhubaneswar 

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